"I think I was trying to suggest something about the duality of man, sir ... the Jungian thing, sir."
Private Joker, Full Metal Jacket

Monday, July 09, 2012

ObamaCare - it whirls - it twirls - it hops - or not.

I was intrigued by Guy Boulton's article on what appear to be wildly
conflicting characterizations of what ObamaCare "will do." He reports on
various explanations for this, including claims by some that the
administration has "failed to sell" the plan and others who blame our
contentious political environment.

The argument that "we just haven't explained things well" is a
time-honored dodge in American politics. It is almost always wrong. The
number of speeches given by the President in support of the new law is
exceeded only by the number of rounds of golf he has played. He's
selling. The public is not buying.

It is certainly true that our political environment is fraught with
contention, although I'm less certain that this is anymore true today
than it has been at many times in our history.
I'd suggest that one of the reasons that we can't agree on what ObamaCare "does" is because no one really knows.

The Affordable Health Care Act is - and I date myself here - a Rube Goldberg machine
on steroids. For those of you who are unfamiliar with him, Goldberg was a
cartoonist who drew far fetched and complicated devices that would
accomplish simple things - say peeling a potato - in convoluted ways.

ObamaCare is an enormously complex contraption built on a series of
assumptions and deferred decisions. It assumes that one can force
insurance companies to cover everyone at a price largely unrelated to
the risk presented by an insured - if only everyone would buy
insurance. It presumes that everyone will buy insurance if only we can
impose a penalty - no, a tax - that is not as high as the policy will
cost. It gambles that more employers will provide health insurance and
that the cost of a health insurance policy can be lowered if only we
mandate that polices must cover more with less cost sharing and if only
we can penalize - er, tax - employers who fail to provide these more
expensive policies - again, at a level that is less than the cost of
purchasing the policies.

It asks us to assume that Medicare costs can be reduced by appointing
a panel of experts who will "do stuff" that won't involve rationing
care. What is that stuff? No one knows.

As Mona Charen recently wrote, ObamaCare is a 2700 page law that
creates "159 new boards and commissions; more than $500 billion in new
taxes (and counting); the Independent Payment Advisory Board, a
rationing board whose decisions are unreviewable by the courts and
practically untouchable by Congress itself; restrictions on religious
liberty; Medicare cuts; affirmative-action mandates for medical and
dental schools; huge new authority over one-seventh of the U.S. economy
for the secretary of health and human services, and open-ended
regulations of the way doctors and others perform their jobs."

In her book, The Truth About Obama Care, Sally Pipes writes that the
Affordable Health Care Act contains "a dizzying array of rapidly moving
parts. Some whirl clockwise, others twirl counter-clockwise and even
more leap up and down like pogo sticks." Putting aside how we might
attribute which movement to which provision, the point is that the law
contains numerous provisions that could prove disastrous if they don't
go together "just so" and others designed to do contradictory things
that it is hoped will come out "just right."

But it's worse than that. Writing in the Claremont Review of Books,
Charles Kesler writes that Nancy Pelosi's infamous statement that we
must "pass the bill, so that we know what is in the bill" is a misnomer.
Reading the bill tells you precious little about what will actually be
done.Most of that is left to subsequent rule making.

And it gets even worse. The Affordable Health Care Act was passed in
2010. Almost all of its provisions were designed not to go into effect
until after the President runs for re-election this year - in 2012.
When
does that ever happen? Here we have what we are told is the biggest and
bestest reform ever. It is so good that we better not let the public
experience its many blessings until after President Obama is safely
re-elected.

Why do you suppose that is? Here's a hint. It wasn't because the
Obama administration thought that a more rapid implementation of
ObamaCare goodness would make the 2012 campaign too easy. It isn't
because they wanted to give the Republicans a break so as to make the
election more "sporting."

In light of all this, is it any wonder no one can agree on what ObamaCare "will do?"

The beauty of our federal system is that the states can serve as "laboratories of democracy." Over 98% of adults in Massachusetts now have health insurance, and 99.8% of children in Massachusetts have health insurance. Massachusetts residents are overwhelmingly happy with Romneycare.

So we don't need to speculate. We have Romneycare to examine. It works.

About Me

I am President and General Counsel of the Wisconsin Institute for Law & Liberty and an adjunct professor of law at Marquette University Law School. The views expressed here are my own and not those of WILL or Marquette. They are offered in my personal capacity.